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Advocates to encourage Kansas City dental specialists to accept safety net referrals

By Mike Sherry for KHI News Service, Jan. 17, 2013

KANSAS CITY, Mo. – Faced with overwhelming patient demand, local oral health advocates are mounting a campaign to convince more dental specialists to accept safety-net referrals.

“You can never have enough,” said Dr. Mike Jurkovich, dental director for Samuel U. Rodgers Health Center. “The need is so great we’ll probably never be able to meet the need, but we’ve got to start somewhere.”

Jurkovich is co-chair of the Oral Health Access Committee, which formed about a year ago through the Mid-America Regional Council.

Committee members are recruiting specialists through programs such as Wy/Jo Care, an initiative of the Medical Society of Johnson & Wyandotte Counties. Wy/Jo Care has a network of physicians that provides free care to a certain number of low-income, uninsured patients each year.

Safety-net dentists, including Dr. Brett Ferguson at Truman Medical Centers, said one of the greatest needs is for oral surgeons who can remove wisdom teeth or decayed teeth. Patients also need root canals and repair of developmental deformities.

Truman currently is about the only referral source for area safety-net providers who have patients with complex dental needs, Jurkovich said. Nearly half the 18,000 patients seen annually at Truman’s Oral & Maxillofacial Surgery Clinic are uninsured, said Ferguson, head of the clinic.

The clinic operates in four locations with seven oral surgeons and 16 residents from the University of Missouri-Kansas City School of Dentistry. The clinic sometimes stays open until 7 p.m. to meet demand, Ferguson said.

“I’m getting patients from as far away as Oklahoma coming to see me to get teeth out or to treat facial fractures,” he said.

Ferguson also treats dog bites, gunshot wounds, and brain and neck infections that have spread from diseased teeth.

“So if you don’t have enough money for the $70 extraction,” he said, “you know you are not going to pay for that $15,000 hospital (admission)” to treat the infection.

Of Wy/Jo Care’s 470 participating doctors, fewer than three dozens are dentists, said Jacque Amspacker, executive director of the medical society.

The program, which served about 1,800 patients last year, had 75 slots for dental work. But, she does not have anyone who removes wisdom teeth.

“I have people that call and need wisdom teeth removed,” Amspacker said. “It is something I just can’t help them with. There are times we do have to turn people away.”

Dentists are not part of the medical society, Amspacker said, but Wy/Jo Care absorbed a dental program about six years ago that an outside organization was discontinuing.

Amspacker is a member of the Oral Health Access Committee, and she said getting another oral surgeon for Wy/Jo Care is at the top of her list of specialists to add. The program has one oral surgeon now.

The Kansas City area has more than 30 oral surgeons in private practice, Ferguson said, and he said they could make a dent in the safety-net need by setting aside half a day a week for those cases. He also said federally qualified health centers could be of more assistance by setting up rotations with dental residents.

“There are ways to get this done, if there is the desire to get this done,” Ferguson said.

At Wy/Jo Care, Amspacker said, one dentist spent all of last year providing about $6,000 worth of free work to one patient, which included root canals, crowns, and fillings.

It’s too early to know how successful the recruitment effort will be, she said. “I guess we’ll see once we get out there and start approaching the dentists.”

Many area dentists informally provide free care to their low-income patients, said Dr. Merle Nunemaker, a south Kansas City dentist who is president-elect of the Missouri Dental Association.

He said there also are area dentists who provide Medicaid services to children, despite the low reimbursement, and participate in efforts such as Missions of Mercy, a national program that organizes mass dental clinics in cities around the country,

According to the association, at a two-day event held in Springfield in 2011, volunteers saw nearly 2,000 patients and provided about $1.1 million worth of care.

And participants were not just general dentists, Nunemaker said.

“We were all side by side getting everything done that we could in a two-day time period,” he said, “so specialists are donating their time and talent just right along with everybody else.”

The Health Care Foundation of Greater Kansas City is proud to partner with the KHI News Service to provide weekly health stories about health and policy issues impacting the greater Kansas City region. Because it is committed to objective coverage, HCF exercises no editorial control over the content. The KHI News Service is an editorially independent initiative of the Kansas Health Institute.


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